Provider Demographics
NPI:1629729835
Name:DILE, HARLAN LOUIS (FNP-C)
Entity Type:Individual
Prefix:
First Name:HARLAN
Middle Name:LOUIS
Last Name:DILE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 HOLDER ROAD
Mailing Address - Street 2:
Mailing Address - City:LUCAS
Mailing Address - State:KY
Mailing Address - Zip Code:42156
Mailing Address - Country:US
Mailing Address - Phone:270-590-1202
Mailing Address - Fax:
Practice Address - Street 1:456 BURNLEY ROAD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164
Practice Address - Country:US
Practice Address - Phone:270-622-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily